Pre-otolithiasis is characterized by transient vertigo and nystagmus induced by head movements to a particular head position, associated with positional changes. Commonly induced movements include: getting up and lying down in bed, tilting the head forward, tilting the head backward, turning over in bed and turning the head quickly. 1. Rotational vertigo: It is a sudden onset of strong rotational vertigo when the head position is changed, which often lasts within 60 seconds, accompanied by nystagmus, nausea and vomiting. Vertigo and nystagmus disappear quickly after keeping the head position unchanged. 2. Vertigo when changing positions: when lying down in the sitting position, when changing from the lying position to the sitting position, when turning over in bed, often conscious of vertigo when turning sideways to a certain head position, and often waking up from sleep because of vertigo attacks. In severe cases of otolithiasis, vertigo can occur with only a slight movement of the head. After the attack, there is a prolonged feeling of lightheadedness and floating. The duration of the disease varies from a few hours to several months or years. The treatment is usually applied by manipulation, or machine reset, and most of them can achieve a good therapeutic effect. When head movement to a particular head position induces transient vertigo and nystagmus, it is recommended to consult a hospital for diagnosis and treatment.